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Post by margaret on Mar 30, 2009 12:34:24 GMT -5
Hi Laurie -
I just spoke w/ doc's office. They told me they will measure GH, Cortisol and ACTH.
Regarding monitoring protocol - she said doctor will be there when I become hypoglycemic, will be there at end, and will be available throughout. The Nurse Practitioner and Med Asst will be w/ me the whole time.
Does that sound okay?
Thank you!
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Post by justaustin on Mar 31, 2009 8:24:45 GMT -5
Margaret, Verify with them that they obtain baseline ACTH,GH and cortisol levels prior to stimming.
Glad you won't be left alone. Sounds like you will be in good hands..having at least one licensed medical professional with you at ALL times.
Laurie
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Post by margaret on Mar 31, 2009 14:58:32 GMT -5
Thank you. I verified it. Test is on April 9th.
What should I be looking for in my results?
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Post by justaustin on Apr 4, 2009 9:02:42 GMT -5
You will need to ask your doc this. Every lab and insurance company has their criteria. For insurance companies to justify paying for growth hormone, I THINK that they look to see if your growth hormone stims to 3.
Sign a release form so that you may receive your results(with reference ranges).
Laurie
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Post by margaret on Apr 8, 2009 11:04:49 GMT -5
I' m paying for this out of pocket. What I'm asking is what results might the doctor consider normal, but those of you on this group may dispute (like, for example, when the docs say a cortisol is normal because it's in range and you guys say it should be in upper range). I'm asking because I want to be prepared when they give me the results to argue if they say I'm normal but to you guys I would be sub-optimal. Does that make sense?
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Post by justaustin on Apr 8, 2009 12:19:38 GMT -5
Bearing in mind that Normal and Optimal do not mean the same!! Healthy/optimal morning ACTH should be in upper 1/3 of range. So, high 30(depending on range) and higher. Old range used to go to 60. Read Chris' Wikipedia article on ACTH stim. With an ACTH stim, if baseline cortisol is low and baseline ACTH is less than upper 1/3 range, and you have a terrific response(at least double,triple,quadruple) then that argues for secondary adrenal insuffiency. This is due to giving your body much needed and obviously lacking ACTH and adrenals go hog wild. This will not be the case with ITT. I think that regardless of being primary AI or secondary AI..... By provoking stress (and hypoglycemia is stressful), with adrenal insufficiency.... your cortisol will either decrease, remain the same or increase very little. You will not see a dramatic increase. This is why it is IMPERATIVE to have baseline ACTH and cortisol levels prior to stim. Unfortunately, most people have ACTH stims around here which is a different ball of wax. With respect to growth hormone. They look to see if your peak growth hormone level will increase to either 3 or 5(depends on doc/lab/insurance company). If it fails to peak to whatever threshold, you are classed as gh deficient. Read this thread about Carol's Arginine Stim test for growth hormone. I would think the same would apply or be very similar with ITT. See growth hormone produced in pulsitile fashion when glucose is at it's lowest, growth hormone should increase. hormonesupportgroup.proboards.com/index.cgi?action=display&board=hypopituitary&thread=110&page=1#654Even if you call and leave message for doc to call you a week prior to stim testing. So, you aren't stressing about it prior to it. Hope this helps(somewhat), Laurie
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Post by margaret on Apr 9, 2009 18:30:14 GMT -5
Yes, thanks!
I survived the test, I did it today and go back in 3 weeks for the results.
It was very interesting.
I'll keep you posted.
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Post by justaustin on Apr 13, 2009 20:16:30 GMT -5
Hi Margaret,
Please keep us updated. Do tell me(either in post or PM) of your "interesting" experience.
You are welcome, Laurie
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